If you are hearing about malignant narcissism for the first time, you may be wondering how is that different from narcissistic personality disorder or simply narcissism. Isn’t narcissism malignant in itself? To understand the difference between narcissism, narcissistic personality disorder and malignant narcissism, we should first define each of these terms.

Narcissistic Personality Disorder

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Narcissistic personality disorder is a destructive preoccupation with one’s own personal adequacy, power and prestige. People with this disorder crave for admiration, have an unreasonably strong sense of entitlement and are often preoccupied with unrealistic fantasies of success, beauty and ideal love. Unlike malignant narcissism, narcissistic personality disorder is defined as a mental illness in DSM-V (Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition).

Narcissism

According to PsychCentral, the term “narcissism” is simply a layman’s term for someone with narcissistic personality disorder. However, Dr. Allan Schwartz (MentalHelp.net) argues that there is a distinct difference between simple narcissism and narcissistic personality disorder. According to him, narcissistic personality disorder is a mental illness, whereas narcissism — although characterized by somewhat similar behaviors — is not classified as a mental illness.

Some of you reading this may feel that these two statements contradict each other and they do to a certain degree. It’s probably safe to say that anyone with narcissistic personality disorder is a narcissist, but not every narcissist has a narcissistic personality disorder. For example, Bill Gates, Larry Ellison and Steve Jobs are often referred to as narcissists[1], but they were never diagnosed with a mental illness. On the other hand, it is often said that it’s highly likely that Adolf Hitler[2], Joseph Stalin and Napoleon Bonaparte suffered from narcissistic personality disorder, hence were mentally ill.

Another indication that Dr. Schwartz’s article has more insight is the existence of another term, “healthy narcissism”. Healthy narcissism simply means healthy and realistic self-esteem with no damage to one’s emotional life[3].

Having said that, while Dr. Schwartz may indeed have a point, it’s important to know that using the terms “narcissism” and “narcissistic personality disorder” interchangeably is extremely common and, to a certain extent, acceptable.

Malignant narcissism

Campbells’ Psychiatric Dictionary defines malignant narcissism as a mix of narcissism, antisocial personality disorder, aggression and sadism. It is important to mention that malignant narcissism was not included in the latest edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and is not considered to be a diagnostic term.

To understand this a little better, here is an example from DSM-V Self-Exam Questions:

The correct answer is D (narcissistic personality disorder and antisocial personality disorder). The reason why answer B would be incorrect is that malignant narcissism is not a diagnostic term. This means that while the young man from the above example fits the description of malignant narcissism, he will not be diagnosed with it simply because “malignant narcissism” is a hypothetical term. Instead, this young man will be diagnosed with two other disorders, because they appear to be most disruptive to his life. If you think about it, malignant narcissism by its current definition is nothing more than a mix of personality disorders and abnormal behaviors, so giving a more precise diagnosis makes a lot of sense. You can read through explanation of this example online here (18.13).

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